Neurocognitive outcomes following postoperative paediatric cerebellar mutism syndrome: A systematic review.

Abstract

Aim: To systematically review neurocognitive outcomes associated with postoperative paediatric cerebellar mutism syndrome (pCMS), comparing children with and without pCMS after posterior fossa tumour surgery, and in relation to moderating demographic and clinical risk factors.

Method: PsycInfo, Medline, and Embase databases were systematically searched up to December 2024. Studies of children aged 2 to 18 years with pCMS who had undergone standardized neurocognitive assessment were included. Quality was appraised using Institute of Health Economics Quality Appraisal Checklist for Case Series and Quality In Prognosis Studies tools. Synthesis without meta-analysis was conducted.

Results: Sixteen studies (n = 252 children presenting with pCMS, n = 590 without) met criteria for inclusion. Children who experienced pCMS were found to have pronounced, long-term neurocognitive impairments with severely affected processing speed, psychomotor and executive function, and poorer neurocognitive outcomes generally than children without pCMS. Current literature is limited by small samples, lack of diagnostic clarity or routine prospective screening of pCMS, and limited investigation of factors that may moderate neurocognitive outcomes.

Interpretation: Children with pCMS have increased vulnerability to neurocognitive impairments which persist beyond the recovery of initial symptoms in the postoperative phase. Dedicated research is needed to further our understanding of the condition and moderators of neurocognitive outcomes to inform clinical care.